Home' Australian Ageing Agenda : AAA MAR-APL 2018 Contents Chart 1
and capacities will increasingly influence how
our health and aged care systems operate.
Frailty and related issues will increasingly
underpin our responses to the oldest old
because we need to combine and integrate
knowledge of this group across a variety of
professions and industries.
For example, the relationship of ageing to
disability will grow significantly in coming decades.
Even now the definition of oldest old usually refers
to those aged 85 and over but sometimes 80 and
over is seen as sufficient for planning and ser vice
response purposes. And of course variation does
occur in the profiles of particular populations, so
these categories should be seen as being subject to
change as our understanding of ageing develops.
As detailed in an article in the January-Februar y
issue of Australian Ageing Agenda, we argue
that knowing where the oldest old are currently
living and where their numbers are rising or
falling will be a powerful indicator of change and
opportunity in aged care.
The demand for particular types of aged care
and ser vices focusing on frail older peoples’
needs, can be better estimated and contextualised
through locational analysis. The often ver y
local worlds of the ver y old also mean that scale
and distance are important considerations for
ensuring this group are able to access ser vices
close to their residence.
The physical dislocations that can occur in
aged care is something that we know is to be
avoided where possible, especially where older
people are embedded in their local communities.
Since the majority of supports are still family and
community, knowing where the older person
and their social supports are located is key to
maintaining them in a community context. It is
also optimal for transferring them to local formal
support ser vices if and when the time comes. The
sustainability of aged care in the longer term will
be locationally driven.
While population ageing is an increasingly global
phenomenon, we also know the rates of ageing
and particular trajectories of ageing var y by
countr y and region.
In Australia, South Australia and Tasmania
are ageing faster than other states. In addition,
we can expect that similar differences are
emerging between the regions and cities, and
even within major metropolitan areas. Ageing
is about diversity on multiple levels and the
geography of ageing is increasingly important as
Chart 1 shows how this pattern is unfolding
for New South Wales. In little over a decade,
the population aged 65 and older has increased
significantly from under one million people to
more than 1.2 million.
In NSW, the profile of the aged is still on the
younger side, with growth in numbers highest in
the 65 to 74 cohorts, and growth in the 75 to 84
cohorts remaining flat for the time being.
But, as the maps also show, the overarching
pattern of ageing is gradually spreading across
At the same time, some parts of the city and
the broader Sydney region have much younger
demographics, which demands consideration of
potential issues for older people living in those
areas – such as GP access and public transport.
Where are they now?
The two maps (overleaf), for people aged 85
and over for the 2006 and 2016 censuses, clearly
illustrate population ageing and the implications
for location. While these maps are for the greater
Sydney area, any city or region will exhibit its
This also provides some sense of the difference
between a general pattern of population ageing,
its speed in particular areas and the specific
trajectories experienced by location.
In other words, with a spatial approach we can
take into account a broad population pattern and
combine it with the specifics of local areas, all
within the same data environment.
Implications for aged care
The growth in the total number of older people
is a driver for all kinds of ser vice providers, from
acute health and residential care to community-
based physiotherapists and podiatrists.
As our understanding of ageing improves
we can expect the scope of ser vices to expand
as new conditions and associated needs are
identified. The complexities of age-related
health, cognitive functioning and physical
mobilities are likely to see further diversification
as our knowledge base improves.
All of these complex variables exhibit highly-
specific spatial patterns. Taking a geographic
approach to population ageing and its
consequences provides us with the tools for a more
effective response to ageing and its consequences.
These patterns can be visualised through
mapping and then other factors added to the
mix, such as GP availability, pharmacy and
residential care locations.
Location of, and distance to, supports remains
one of the enduring complexities of ageing in
contemporar y society. n
Hamish Robertson is a health and medical
geographer currently managing a project on
visualising vulnerabilities in healthcare at
the University of Technology Sydney. Nick
Nicholas is a demographer and geographic
information systems specialist.
is key to
them in a
australianageingagenda.com.au | 27
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